Procedures on the newly deceased: An ethical and educational challenge

Introduction: The newly deceased patients have long been usedin medical schools to teach clinical skills without any challengesas it helps to train skilled doctors. Nowadays, the use of moulagesand simulators are common in teaching clinical skills since thesetools provide the opportunity for frequent practice without anypain and injury. There are specific procedures which still requirethe use of cadavers. However, the increased significance ofpatient rights has generally challenged the practicality of usingthe deceased bodies for this purpose. This study was designedwith the aim of determining to what extent clinical skill trainingis dependent on the recently deceased patients.Methods: This was a cross-sectional mixed-method triangulationdesign conducted in two phases. In the first phase, a researcher-madequestionnaire was used to collect quantitative data of the medicalstudents and residents. The data were used to assess the frequencyof experience. In the second stage, semi-structured interviews wereconducted with faculty members and fellows in order to evaluatethe educational impact of this type of procedure and the influentialfactors. The quantitative data were analyzed using statisticalsoftware, and the qualitative codes were extracted following acontent analysis. Finally, a comparative analysis was performed.Results: Twenty five residents (26%) and seven medical students(14%) had the experience of performing procedures on therecently deceased patients for training purposes. About half ofthe residents and 33% of the medical students had observed theircolleagues practicing procedures on cadavers. In the qualitativephase, the main categories included professional ethics, law andeducational requirements.Conclusion: A relatively low number of medical students andresidents had experienced procedures on the newly deceasedpatients. In this regard, ethical, religious and legal concerns mighthave played a part despite the desire to learn. It would be effectiveto direct these educational experiences toward proceduresthat cannot be mastered through moulages and simulators, andto lay the legal and executive ground so that performing theseprocedures under the supervision of professors, and with a levelof documentation would have no legal challenges.Keywords: Cadaver, Learning, Clinical skills, Ethics